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Use of acid-suppressive drugs during pregnancy and the development of toddler asthma

Published Online: September 3, 2013

Gastro-Acid-suppressive drugs are considered effective and safe to use during pregnancy to treat gastro-oesophageal reflux disease (GERD). Recent studies reported a causal relation between prenatal exposure to acid suppressive drugs and the development of childhood asthma but unmeasured confounding could not be ruled out.

In a Letter to the Editor in The Journal of Allergy & Clinical Immunology (JACI), Mulder et al. investigated the association between prenatal exposure to acid suppressive drugs and toddler asthma with a confounding minimizing case-crossover design.

This study was performed with data from the Groningen prescription database IADB and compared 1,253 children with asthma with 1,253 of their own siblings without asthma. Children were identified as having asthma with the aid of dispensed prescriptions for asthma medication. All children could be followed in the database for at least 5.5 years from birth. Maternal exposure was defined as receiving at least one prescription for either proton pump inhibitors, histamine-2-antagonists or other drugs for GERD during pregnancy.

The authors found that the use of acid suppressive drugs during pregnancy was associated with the development of asthma in children. The validity of previous reported results are supported by this study because findings showed the minimal influence of confounding in these associations. However, more study for example of the mechanism or development of other atopic conditions in relation to acid suppressive drugs, is now warranted, and the benefit risk-balance of such drugs should be reconsidered during pregnancy.

The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.